Predictive factors for 1-year outcome of chronic low back pain following manipulation, stabilizing exercises, and physician consultation or physician consultation alone

To examine the relative influences of sociodemographic and episode-specific factors on change in low back pain intensity and self-rated disability. Of 204 patients with chronic low back pain, 102 were randomized to a combined manipulation, exercise and physician consultation group and 102 to a consu...

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Bibliographic Details
Published in:Journal of rehabilitation medicine 2004-05, Vol.36 (3), p.104-109
Main Authors: Niemistö, Leena, Sarna, Seppo, Lahtinen-Suopanki, Tiina, Lindgren, Karl-August, Hurri, Heikki
Format: Article
Language:English
Subjects:
Adult
Chronic Disease
Chronic low back pain
Consultation
Demography
Exercise
Exercise Therapy - methods
Female
Finland
Humans
Low Back Pain - rehabilitation
Low Back Pain - therapy
Male
Manipulation
Manipulation, Orthopedic - methods
Middle Aged
Outcomes
Predictive Value of Tests
Psychosocial factors
Referral and Consultation
Treatment Outcome
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Summary:To examine the relative influences of sociodemographic and episode-specific factors on change in low back pain intensity and self-rated disability. Of 204 patients with chronic low back pain, 102 were randomized to a combined manipulation, exercise and physician consultation group and 102 to a consultation-alone group. These groups were each divided into 2 clusters based on change in both pain intensity and self-rated disability at 1 year. The first cluster included patients whose symptoms clearly decreased, and the second those whose trouble persisted. Association between sociodemographic and episode-specific factors and poor recovery from low back pain and disability were evaluated by univariate and multivariate analysis. Severe affective distress (OR 3.81; 95% CI 1.3-10.8) predicted poor response to the manipulative treatment. Over a 25-day sick leave during previous year (19.64; 3.8-102.5), poor life control (9.40; 1.9-47.0), and generalized somatic symptoms (3.18; 0.9-11.6) were the risk factors for not benefiting from the informative approach. Psychosocial differences seem to be important determinants for treatment outcomes, and should be the focus of future studies.
ISSN:1650-1977
1651-2081
DOI:10.1080/16501970310019151